Health surveillance for occupational asthma

Purpose of review The outcome for workers with occupational asthma is improved for those with an earlier diagnosis. Health surveillance at work is in principle designed to identify such cases, so that the risks to the individual worker, and coworkers, can be reduced. There is recent evidence to suggest that the uptake and quality of such surveillance could be improved. This review has assessed current approaches to health surveillance for occupational asthma. Recent findings The article covers a review of the utility of questionnaires, lung function testing, immunological investigations, and other tests, including exhaled nitric oxide, sputum eosinophilia, and exhaled breath condensate specifically in the context of workplace-based health surveillance. Summary Questionnaires remain a key component of respiratory health surveillance, although maybe limited by both sensitivity and specificity for early occupational asthma. The role of lung function testing is debated, although is recommended for higher level health surveillance. Various examples of immunological testing in health surveillance are discussed, but more evidence is needed in many specific areas before more general recommendations can be made. Evidence is discussed in relation to the utility of newer approaches such as exhaled nitric oxide, sputum eosinophilia, and exhaled breath condensate. Correspondence to David Fishwick, MBChB, FRCP, AFOM, MD, Centre for Workplace Health, Science Division, Health and Safety Executive of Great Britain, Harpur Hill, Buxton, Derbyshire, SK179JN, UK. Tel: +0203 028 2214; e-mail: d.fishwick@sheffield.ac.uk;david.fishwick@hsl.gsi.gov.uk The contents of this publication reflect the views of the authors alone and not necessarily those of HSE policy. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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